Bon Secours Mercy Health provides a useful example of how large healthcare organizations can use automation to improve administrative operations and financial performance. Its experience includes automated insurance eligibility checks, authorization processing, medical necessity verification, patient financial estimates and claims status activities.
The bon secours mercy health robotic process automation case studies search reflects an interest in understanding how automation works in a real hospital environment and whether similar approaches can improve operational efficiency.
One important distinction is necessary. Not every automation initiative at Bon Secours Mercy Health is documented as robotic process automation or RPA. Some involve automated revenue cycle technology, integrated electronic health record workflows and artificial intelligence. These technologies can produce similar efficiency improvements but operate differently.
The following analysis examines documented automation initiatives, their reported results and the practical lessons healthcare organizations can apply.
Key Takeaways
- Bon Secours Mercy Health has used automation to improve revenue cycle operations and reduce manual administrative work.
- Automated eligibility and authorization workflows helped improve pre-registration performance.
- Revenue cycle automation supported the reallocation of 118 full-time employees.
- Automation results included improved point-of-service collections and increased net revenue.
- Successful healthcare automation requires workflow integration, human oversight, compliance and measurable performance goals.
How Bon Secours Mercy Health Used Automation in Revenue Cycle Operations
One of the most relevant documented examples involves the health system’s revenue cycle operations and its work with Ensemble Health Partners.
Healthcare organizations handle thousands of administrative transactions involving insurance companies and patients. Many of these tasks require employees to access multiple systems and repeatedly verify information.
Bon Secours Mercy Health adopted technology that automated several of these activities within its existing healthcare information systems.
1. Automated Insurance Eligibility and Authorization
Documented implementation
In 2018 Recondo Technology introduced its RevSmart platform. Bon Secours Mercy Health became one of its early customers alongside Ensemble Health Partners.
The solution integrated automated payer communication into Epic through real-time eligibility and authorization capabilities.
Previously, financial clearance activities required substantial administrative coordination. Staff had to verify insurance coverage and confirm whether services required authorization before patients received care.
The automated workflow supported:
- Real-time insurance eligibility verification.
- Authorization processing.
- Medical necessity verification.
- Pre-service patient financial estimates.
- Automated communication with insurance payers.
- Claim status tracking through a related solution.
By integrating these activities into existing workflows, the organization could reduce repetitive administrative work and improve the availability of financial information before appointments.
Reported results
The implementation and associated workflow improvements produced several reported outcomes:
- 50% improvement in pre-registration and authorization days out.
- 95% increase in point-of-service collections during the first six months.
- 118 full-time employee equivalents reallocated through operational automation.
- Approximately $7.6 million in associated FTE cost savings.
- $15 million in additional net revenue over one year.
These results were attributed to the combined technology implementation and Ensemble’s operational optimization. They should not be interpreted as savings generated by software alone. PR Newswire+1
2. Automated Claims Status and Business Office Workflows
Another important part of the automation strategy involved claims management.
After a healthcare provider submits a claim to an insurance company, the organization must track its progress. Employees may need to check whether a claim has been received, processed, approved, denied or delayed.
Without automation these activities can create substantial administrative workloads.
Bon Secours Mercy Health used Recondo’s ClaimStatusPlus solution in its business office to support automated claim status activities.
This type of workflow automation helps reduce repetitive payer follow-ups and allows employees to focus on claims that need investigation or additional documentation.
Key activities include:
- Retrieving claim status information.
- Identifying claims that require additional attention.
- Reducing repetitive manual status checks.
- Supporting more organized follow-up workflows.
- Improving visibility into outstanding claims.
The important lesson is that automation can support different stages of the revenue cycle rather than focusing on a single administrative task.
However the publicly reported results do not isolate the financial contribution of ClaimStatusPlus from the broader revenue cycle improvements. PR Newswire+1
Additional Automation Initiatives at Bon Secours Mercy Health
Revenue cycle automation is not the only area where the organization has invested in improving administrative processes.
Its more recent technology initiatives demonstrate how automation is expanding into patient communication and workforce operations.
3. Patient Contact Center and Appointment Scheduling Automation
Documented implementation
Bon Secours Mercy Health modernized its patient contact center using Genesys Cloud CX.
The initiative focused on improving patient access, simplifying appointment scheduling and reducing the workload associated with handling incoming calls.
The system integrated with Epic and introduced capabilities such as:
- Improved interactive voice response systems.
- Patient self-service options.
- AI-powered agent assistance.
- Automated after-call work.
- Appointment scheduling support.
- Workforce engagement and performance monitoring.
One important feature was the use of AI-powered agent copilots.
Scheduling medical appointments can be complicated because patients may describe their needs using different medical terms or incomplete information. Agent assistance tools provide relevant knowledge and prompts to help representatives handle these conversations.
Reported results
| Performance measure | Reported improvement |
|---|---|
| Appointments scheduled per week | 13% increase |
| Revenue generated per contact center agent | 10% increase |
| Call handling time | 20–30 seconds saved per call |
| Patient self-service for appointment information | Approximately 4% of callers |
These results demonstrate how intelligent workflow assistance can improve contact center productivity without requiring every patient interaction to be handled manually.
The reported financial improvement was associated with the contact center implementation and included consideration of copilot licensing costs. a Genesys customer success story
4. Workforce and Operational Process Modernization
Another area of operational improvement involves workforce management.
Large hospital systems must coordinate employee schedules with changing patient demand. Manual scheduling and inconsistent incentive processes can make this difficult.
Bon Secours Mercy Health has also pursued workforce modernization through automated incentive pricing, structured participation programs and forecasting tools.
A reported result from its PRN workforce program was a 25% increase in pre-scheduled hours during a holiday period.
This example is different from traditional RPA because it involves workforce management technology and automated decision support rather than simply using software robots to repeat computer tasks.
Nevertheless it demonstrates an important principle: automation can improve resource allocation as well as administrative processing. Mo Health & Senior Services
Bon Secours Mercy Health Automation Results at a Glance
The following table separates the documented initiatives and their reported outcomes.
| Initiative | Technology or approach | Reported outcome |
|---|---|---|
| Insurance eligibility and authorization | Recondo RevSmart with Epic | 50% improvement in pre-registration and authorization days out |
| Patient financial collections | Automated financial clearance and workflow optimization | 95% increase in point-of-service collections |
| Revenue cycle workforce | Workflow automation and operational optimization | 118 FTEs reallocated |
| Revenue cycle financial performance | Combined automation and operational improvements | $15 million additional net revenue in one year |
| Patient contact center | Genesys Cloud CX and AI agent assistance | 13% more appointments scheduled weekly |
| Contact center efficiency | Agent assistance and workflow improvements | 20–30 seconds saved per call |
| Workforce scheduling | Workforce management modernization | 25% increase in pre-scheduled PRN hours during a holiday period |
FTE means full-time equivalent. The results come from different initiatives and reporting periods. They should not be added together or treated as the outcome of one RPA deployment.
Was This Traditional Robotic Process Automation or Intelligent Automation?
Understanding the technology behind these initiatives is important when evaluating the bon secours mercy health robotic process automation case studies.
The organization has documented several types of automation, but the available public evidence does not establish that all these projects used traditional RPA bots.
Traditional RPA uses software robots to perform repetitive tasks through predefined rules and workflows.
For example a bot might:
- Open an approved application.
- Retrieve an insurance record.
- Compare information against predefined rules.
- Enter verified information into another system.
- Record the transaction.
- Send an exception for human review when information is incomplete.
This is different from an integrated eligibility platform that communicates directly with a payer through an application interface.
It is also different from AI that interprets information or provides recommendations to employees.
Comparing the Main Automation Technologies
| Technology | Primary function | Healthcare example |
|---|---|---|
| Traditional RPA | Repeats rule-based computer tasks | Transferring verified information between applications |
| Workflow automation | Coordinates tasks and approvals | Routing authorization requests |
| API integration | Exchanges data between systems | Connecting Epic with payer services |
| Artificial intelligence | Analyzes information and supports decisions | Assisting contact center agents |
| Intelligent automation | Combines automation with AI and integrations | Coordinating complex administrative workflows |
These technologies can work together. A healthcare organization might use an API for reliable data exchange, RPA for a legacy application without integration capabilities and AI for interpreting unstructured information.
The correct technology depends on the process rather than the popularity of a particular automation platform.
Why Revenue Cycle Operations Were a Strong Automation Opportunity
Revenue cycle management involves several interconnected activities that determine how healthcare providers receive payment for their services.
These processes begin before a patient receives care and continue until the associated claims and payments are resolved.
Several characteristics make revenue cycle operations suitable for automation.
High Transaction Volumes
Hospitals process large numbers of patient accounts, insurance checks and claims.
When employees perform every repetitive activity manually, the workload increases as patient volumes grow.
Automation can handle predictable transactions while employees concentrate on exceptions and complex cases.
Repetitive Administrative Tasks
Insurance verification and claim status checks often follow established procedures.
When the required information is available electronically and the process follows clear rules, these tasks can be candidates for automation.
Multiple Systems and Payer Requirements
Healthcare employees often work across electronic health records, billing applications and payer portals.
Integrating these systems can reduce unnecessary switching between applications and repeated data entry.
Financial Impact of Delays
Administrative delays can affect billing timelines and payment collection.
Automating selected activities before service delivery can help identify missing information earlier and reduce avoidable downstream work.
However automation cannot resolve every denial or payment issue. Incorrect clinical documentation, coverage exclusions and payer disputes still require appropriate human investigation.
What Healthcare Organizations Can Learn From These Automation Projects
The experience of Bon Secours Mercy Health offers several practical lessons for healthcare providers considering similar investments.
1. Start With High-Volume Administrative Processes
Not every hospital process needs automation.
Organizations should first identify activities that consume substantial employee time but follow predictable rules.
Good starting points include:
- Insurance eligibility checks.
- Authorization status tracking.
- Patient registration.
- Claims status inquiries.
- Routine billing data entry.
- Document routing.
These processes are easier to evaluate because their inputs and expected outputs can be clearly defined.
2. Integrate Automation With Existing Healthcare Systems
Automation should fit into existing operations rather than create another disconnected system.
For organizations using Epic or another electronic health record platform, integration capabilities should be evaluated before selecting an RPA vendor.
A direct integration may be more reliable than a software robot that interacts with application screens.
However RPA can still be useful when older applications lack suitable integration options.
3. Keep Employees Involved in Complex Decisions
Healthcare administration involves financial, legal and patient-related decisions.
Automation should handle predictable tasks while employees retain responsibility for situations involving:
- Conflicting insurance information.
- Complex authorization requirements.
- Unusual billing situations.
- Incomplete patient records.
- Disputed claims.
- Compliance concerns.
Human oversight also helps organizations identify automation errors before they affect larger numbers of accounts.
4. Measure Financial and Operational Performance Separately
A successful automation project should demonstrate improvements beyond the number of tasks completed.
Healthcare leaders should monitor:
| KPI | What it measures |
|---|---|
| Processing time | Time required to complete an administrative task |
| Automation rate | Percentage of eligible transactions completed automatically |
| Exception rate | Transactions requiring employee intervention |
| First-pass accuracy | Transactions completed correctly without rework |
| Claim denial rate | Percentage of claims denied |
| Days in accounts receivable | Average time required to collect outstanding payments |
| Cost per transaction | Operating expense associated with each processed transaction |
| Employee productivity | Work completed per employee |
Tracking these measures before and after implementation helps determine whether automation is creating measurable value.
HIPAA Compliance and Security Considerations for Healthcare Automation
Healthcare automation systems may access electronic protected health information. This creates additional responsibilities for healthcare organizations.
Under the HIPAA Security Rule organizations must implement appropriate administrative, physical and technical safeguards to protect electronic protected health information.
Important considerations include:
Access control: Automation accounts should only access information necessary for their assigned tasks.
Authentication: Systems should use appropriate authentication controls to prevent unauthorized access.
Audit trails: Organizations should maintain records of automated activities including access and changes to information.
Data protection: Sensitive information should be protected during storage and transmission.
Risk assessment: Healthcare organizations should evaluate potential vulnerabilities before deploying automation.
Vendor agreements: Third-party service providers handling protected health information may need appropriate business associate agreements.
An RPA implementation should also include procedures for failed transactions, unauthorized access attempts and system interruptions.
The goal is to make automation efficient without compromising patient information or operational accountability. HHS.gov+2
How to Evaluate an RPA Investment for a Healthcare Organization
The Bon Secours Mercy Health experience provides useful examples, but another hospital should not automatically expect identical financial results.
Its operating environment, transaction volumes, existing systems, staffing structure and vendor arrangements may be very different.
A more reliable approach is to evaluate automation opportunities using a structured decision framework.
Step 1. Calculate the Existing Manual Workload
Identify how many transactions employees complete each month.
For example consider a hospital that manually processes 20,000 insurance eligibility checks every month.
Measure:
- Average processing time per check.
- Number of employees involved.
- Frequency of errors.
- Time spent correcting incomplete records.
- Existing software and labor expenses.
This establishes the baseline for measuring potential improvements.
Step 2. Identify the Most Suitable Automation Method
Different processes require different technologies.
| Business requirement | Potential solution |
|---|---|
| Repetitive data entry | Traditional RPA |
| Automated payer communication | API integration |
| Multi-step administrative approvals | Workflow automation |
| Complex document interpretation | AI-assisted automation |
| Legacy system interaction | RPA where integration is unavailable |
A hybrid approach may be more suitable when multiple systems are involved.
Step 3. Estimate the Financial Return
Calculate the expected benefits using realistic operating assumptions.
A basic ROI formula is:
\[ ROI = \frac{\text{Annual Benefits – Annual Costs}}{\text{Annual Costs}} \times 100 \]
Include both direct and indirect costs.
Potential benefits:
- Reduced manual processing time.
- Lower overtime expenses.
- Fewer data entry errors.
- Less repetitive follow-up work.
- Improved collections.
- Greater employee capacity.
Potential costs:
- Software licensing.
- Implementation services.
- System integration.
- Maintenance and monitoring.
- Employee training.
- Security and compliance work.
Avoid treating every saved employee hour as an actual cash saving. Some benefits represent increased capacity rather than reduced payroll expenses.
Step 4. Run a Controlled Pilot
Instead of automating an entire revenue cycle operation immediately, select one process.
Insurance eligibility verification is a possible starting point because the workflow can often be measured clearly.
During the pilot:
- Document the existing workflow.
- Define automation rules.
- Establish exception-handling procedures.
- Test with representative transactions.
- Compare accuracy and processing time.
- Review security and compliance controls.
- Expand only after the results meet predefined targets.
Expert Decision: Should a Hospital Choose RPA, API Integration or Intelligent Automation?
The best choice depends on the underlying problem.
Choose traditional RPA when:
- Employees repeatedly enter the same information.
- Existing applications lack integration capabilities.
- Tasks follow predictable rules.
- The process has clearly defined exceptions.
Choose API integration when:
- Two systems need to exchange structured information.
- Reliable and frequent data communication is required.
- Both systems support appropriate integration interfaces.
- Maintaining screen-based bots would create unnecessary complexity.
Choose intelligent automation when:
- Documents contain unstructured information.
- Tasks require classification or interpretation.
- AI assistance can improve employee productivity.
- Human review remains available for important decisions.
For most large healthcare organizations, the strongest approach may combine these technologies rather than rely on one solution.
The key is to automate the process using the simplest technology that meets operational, security and financial requirements.
Frequently Asked Questions
1. What are the Bon Secours Mercy Health robotic process automation case studies about?
The bon secours mercy health robotic process automation case studies primarily relate to administrative and revenue cycle automation. Documented initiatives include automated insurance eligibility, authorization processing, financial clearance and claims status activities.
However the public evidence describes a broader automation strategy rather than confirming that every initiative used traditional RPA bots.
2. Which automation platform did Bon Secours Mercy Health use?
One documented implementation involved Recondo Technology’s RevSmart platform integrated with Epic. The organization also used Recondo’s ClaimStatusPlus solution for claims status activities.
Its patient contact center modernization separately involved Genesys Cloud CX.
3. How much money did Bon Secours Mercy Health save through automation?
A documented revenue cycle implementation reported approximately $7.6 million in FTE-related cost savings associated with the reallocation of 118 full-time employee equivalents.
The broader combination of technology and operational improvements also contributed to a reported $15 million increase in net revenue over one year.
These figures describe different financial measures and should not be treated as interchangeable.
4. How did automation improve insurance verification?
Automated financial clearance technology supported real-time eligibility checks and authorization workflows through Epic.
This helped reduce repetitive manual verification activities and made insurance information available earlier in the patient registration process.
5. Did Bon Secours Mercy Health use RPA bots or AI?
Publicly documented initiatives include workflow automation, system integrations and AI-powered assistance.
Traditional RPA bots and AI are different technologies. The available case documentation does not establish that all the reported improvements came from RPA bots.
6. Can smaller hospitals use the same automation approach?
Yes. Smaller hospitals can apply similar principles without investing in a large enterprise automation program.
They can begin with one repetitive administrative process such as insurance verification or claims tracking.
A small pilot with measurable outcomes can help determine whether a larger investment is justified.
7. Which healthcare processes are best suited for RPA?
Common candidates include:
- Insurance eligibility verification.
- Patient registration.
- Claims status tracking.
- Billing data entry.
- Authorization follow-ups.
- Medical record document routing.
- Routine payment reconciliation.
Processes involving complex clinical judgment should not be automated using simple rule-based bots without appropriate safeguards and human oversight.
8. What should hospitals measure before implementing RPA?
Hospitals should establish baseline processing times, transaction volumes, error rates, labor costs and exception rates.
After implementation they should compare these figures with automation costs and actual operational improvements.
This helps distinguish genuine financial savings from improvements in employee capacity.
9. Does healthcare RPA need to comply with HIPAA?
Yes. When RPA systems access electronic protected health information, healthcare organizations must ensure that applicable HIPAA Security Rule safeguards are implemented.
This includes appropriate access controls, authentication, audit controls and risk management.
10. What is the biggest lesson from Bon Secours Mercy Health’s automation strategy?
The most important lesson is that automation works best when it addresses a measurable operational problem.
Instead of introducing software simply to reduce manual work, healthcare organizations should identify inefficient processes, integrate suitable technology into existing systems and measure improvements in financial performance, accuracy and employee productivity.
Applying the Bon Secours Mercy Health Model to Other Healthcare Organizations
The strongest takeaway from these examples is that healthcare automation should be treated as an operational improvement strategy rather than simply a technology purchase.
Bon Secours Mercy Health demonstrated how combining automated financial clearance, integrated healthcare systems and revenue cycle workflow improvements can support better administrative performance.
Organizations considering similar investments should begin with high-volume processes that have measurable costs and predictable rules.
Traditional RPA may be appropriate for repetitive tasks in legacy applications. API integrations are often better for direct system communication, while intelligent automation can support workflows involving more complex information.
The right combination depends on existing infrastructure, transaction volumes, security requirements and expected financial benefits.